Japanese Journal of Clinical Oncology Advance Access originally published online on May 9, 2005
Japanese Journal of Clinical Oncology 2005 35(5):271-273; doi:10.1093/jjco/hyi072
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© 2005 Foundation for Promotion of Cancer Research
Case Report |
False-positive Findings on [18F]FDG-PET Caused by Non-neoplastic Cellular Elements After Neoadjuvant Chemoradiotherapy for Non-small Cell Lung Cancer
1 Department of Thoracic Surgery, 2 Department of Pathology, Saiseikai Central Hospital and 3 Nishidai Clinic, Tokyo, Japan
For reprints and all correspondence: Takashi Ohtsuka, Department of Thoracic Surgery, Saiseikai Central Hospital, 1-4-17 Mita, Minato-ku, Tokyo 108-0073, Japan. E-mail: t-oh{at}remus.dti.ne.jp
Received August 6, 2004; accepted November 20, 2004
We report two patients with non-small cell lung cancer who had a pathologically complete response after neoadjuvant chemoradiotherapy, although they had positive [18F]fluoro-deoxyglucose positron emission tomography ([18F]FDG-PET) scans. They underwent concurrent chemoradiotherapy, which resulted in a partial response determined by computed tomography (CT). While [18F]FDG-PET after chemoradiotherapy was positive, pathological examination showed that the tumors were fibrotic lesions with infiltration of lymphocytes and macrophages, with the appearance of metaplastic epithelial cells. The reasons for the false-positive results on [18F]FDG-PET were considered to be the high uptake of FDG in non-neoplastic inflammatory cellular elements, i.e. macrophages, lymphocytes and metaplastic epithelial cells, and squamous metaplasia induced by chemoradiotherapy. Although several studies demonstrated that [18F]FDG-PET could predict the response of neoadjuvant treatment of non-small cell lung cancer, one should bear in mind that false-positive results could be observed in pathological complete response of non-small cell lung cancer after neoadjuvant chemoradiotherapy.
Key Words: FDG-PET • lung cancer • false positive • chemotherapy • radiation
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